S3350 Improperly Treated Anxiety and Mood Disorders Results in Untreated Inflammation

Abstract

Introduction: It is well documented that patients with inflammatory bowel disease (IBD) are more likely to have anxiety and mood disorder (AMD) comorbidity. Specifically, IBD patient populations will have a depression and anxiety rate of 21.2% and 19.1% respectively, which is increased compared to the general population of 13.4% and 9.6%. Psychological distress can be exacerbated by the activity of a patient’s IBD, as is a decrease in overall quality of life. Unfortunately, AMD can have direct impact on patients maintaining adherence to a treatment plan. Methods: An electronic medical record search for patients within a local outpatient population for patients meeting the inclusion and exclusion criteria, resulting in a research study population of 244. Of the 244 patients in the research study pool, 169/244 (69%) were receiving IBD therapy while 75/244 (31%) were not receiving IBD therapy. Of the 169 patients receiving IBD therapy, 17/169 (10%) patients had AMD comorbidity. Alarmingly, of the 75 patients not receiving IBD therapy, 37/75 (49%) had AMD comorbidity. Of the 244 patients in the research pool, 190/244 (78%) of patients did not have AMD diagnosis while 54/244 (22%) had AMD. Of the 190 patients without AMD comorbidity, 38/190 (20%) were not receiving IBD therapy. Of the 54 patients with AMD comorbidity, an alarming number of patients 37/54 (69%) were not receiving IBD therapy while only 17/54 (31%) of patients with AMD comorbidity were receiving IBD therapy. Results: The retrospective chart analysis demonstrates that of the 54 patients with AMD, 37 (69%) were not receiving IBD therapy. Out of the 75 patients not receiving IBD therapy, 37 (49%) of the patients had AMD. This is alarming given that previous research demonstrates a 20% prevalence of AMD in the general population. Conclusion: This increased rate of AMD is strongly related. In our chart review, patient’s refused IBD therapy due to apathy toward their diagnosis while others simply were not interested in receiving treatment. In order to combat the negative impacts of mental illness on adherence, we recommend using a multifaceted approach that blends both medical and psychological interventions. The authors also recommend utilizing screening tools to gauge the presence of mood disorders in this patient population in order to adequately diagnose and treat this comorbidity. This reinforces the paramount importance of behavioral health being embedded within the treatment of IBD.Figure 1.: Figures A and B demonstrate statistical findings for this research study.